Division of General Internal Medicine, Department of Medicine, University of Washington, 325 9th Ave, P.O. Box 359780, Seattle, WA 98104, USA.
Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA.
Drug Alcohol Depend. 2023 Apr 1;245:109821. doi: 10.1016/j.drugalcdep.2023.109821. Epub 2023 Feb 24.
Screening for unhealthy alcohol use in primary care may help identify patients at risk for negative health outcomes.
This study examined the associations between 1) screening with the AUDIT-C (alcohol consumption) and 2) an Alcohol Symptom Checklist (symptoms of alcohol use disorder) and subsequent-year hospitalizations.
This retrospective cohort study was conducted in 29 primary care clinics in Washington State. Patients were screened in routine care (10/1/2016-2/1/2019) with the AUDIT-C (0-12) and administered the Alcohol Symptom Checklist (0-11) if they had AUDIT-C score ≥ 7. All-cause hospitalizations were measured within 1 year of the AUDIT-C and Alcohol Symptom Checklist. AUDIT-C and Alcohol Symptom Checklist scores were categorized based on previously used cut-points.
Of 305,376 patients with AUDIT-Cs, 5.3% of patients were hospitalized in the following year. AUDIT-C scores had a J-shaped relationship with hospitalizations, with risk for all-cause hospitalizations higher for patients with the AUDIT-C scores 9-12 (12.1%; 95% CI: 10.6-13.7%, relative to a comparison group of those with AUDIT-C scores 1-2 (female)/1-3 (male) (3.7%; 95% CI: 3.6-3.8%), adjusted for socio-demographics. Patients with AUDIT-C ≥ 7 and Alcohol Symptom Checklist scores reflecting severe AUD were at increased risk of hospitalization (14.6%, 95% CI: 11.9-17.9%) relative to those with lower scores.
Higher AUDIT-C scores were associated with higher incidence of hospitalizations except among people with low-level drinking. Among patients with AUDIT-C ≥ 7, the Alcohol Symptom Checklist identified patients at increased risk of hospitalization. This study helps demonstrate the potential clinical utility of the AUDIT-C and Alcohol Symptom Checklist.
在初级保健中筛查不健康的饮酒行为可能有助于识别出有负面健康结果风险的患者。
本研究旨在探讨以下两个方面的关联：1）使用 AUDIT-C（酒精摄入量）进行筛查，2）使用酒精症状清单（酒精使用障碍症状）与随后一年的住院情况。
这是一项在华盛顿州 29 个初级保健诊所进行的回顾性队列研究。在常规护理中，患者使用 AUDIT-C（0-12 分）进行筛查（2016 年 10 月 1 日至 2019 年 2 月 1 日），如果 AUDIT-C 评分≥7 分，还会进行酒精症状清单（0-11 分）测试。所有原因的住院治疗情况在 AUDIT-C 和酒精症状清单后的一年内进行测量。根据之前使用的切点对 AUDIT-C 和酒精症状清单评分进行分类。
在 305376 名接受 AUDIT-C 测试的患者中，5.3%的患者在次年住院。AUDIT-C 评分与住院率呈 J 形关系，AUDIT-C 评分在 9-12 分的患者全因住院风险较高（12.1%；95%CI：10.6-13.7%，与 AUDIT-C 评分在 1-2（女性）/1-3（男性）的对照组相比（3.7%；95%CI：3.6-3.8%），校正社会人口统计学因素后。AUDIT-C≥7 分且酒精症状清单评分反映严重 AUD 的患者住院风险增加（14.6%；95%CI：11.9-17.9%），而评分较低的患者风险较低。
除了低水平饮酒者外，较高的 AUDIT-C 评分与较高的住院发生率相关。在 AUDIT-C≥7 分的患者中，酒精症状清单可以识别出有较高住院风险的患者。本研究有助于证明 AUDIT-C 和酒精症状清单的潜在临床效用。
